Tissue containment systems and related methods

ABSTRACT

A tissue containment system includes a bag body, a member extending from the bag body and defining a channel, and a viewing window. The bag body at least partially defines an interior region configured to contain a loose tissue specimen and defines an opening sized to receive the loose tissue specimen. The bag body is configured such that a first portion of the bag body can be disposed in an abdominal cavity of a patient while a second portion of the bag body extends outside of the patient. The viewing window is at least partially transparent and provides a seal between the interior region of the bag body and an ambient environment. The channel of the member is configured to receive a tissue visualization device that can be used to view the interior region of the containment bag through the viewing window.

CROSS REFERENCE TO RELATED APPLICATION

This application is a continuation of and claims priority under 35U.S.C. § 120 to U.S. patent application Ser. No. 15/937,911, filed onMar. 28, 2018, which claims priority to U.S. Provisional PatentApplication No. 62/511,007, filed on May 25, 2017. The entire contentsof each of these priority applications are incorporated herein byreference.

TECHNICAL FIELD

This disclosure relates to tissue containment systems, related methods,and more particularly to containing tissue morcellated within a bodycavity.

BACKGROUND

Laparoscopic surgery is a type of minimally invasive surgery in whichprocedures may be performed through small openings (e.g., incisions) inan abdominal wall. In many cases, such procedures involve removal oftissues that are suspected of being pathological. In order to remove atissue mass that is larger than a size of an incision in the abdominalwall, the tissue mass may be reduced in size (e.g., ground up) by amorcellator that has been introduced into the abdominal cavity andwithdrawn (e.g., suctioned) from the abdominal cavity through themorcellator. The morcellation process can undesirably spread (e.g.,eject) trace amounts of ground tissue within the abdominal cavity, whichcan unintentionally upstage a disease state in cases where the tissuemass proves to be malignant or otherwise progressive. Therefore, it canbe beneficial to contain and isolate morcellated or otherwise reducedtissue from the abdominal cavity during a tissue reduction processcarried out within the abdominal cavity.

SUMMARY

This disclosure relates to tissue containment systems and methods ofusing the tissue containment systems during surgical procedures (e.g.,laparoscopic procedures). Such tissue containment systems include acontainment bag that has a single opening, while having multiple accessports that may be used for procedural steps, such as introducing atissue removal device (e.g., a morcellator) into the containment bag,manipulating tissue within the containment bag, and visualizing tissuewithin the containment bag.

In one aspect, a tissue containment system includes a containment bagconfigured to be placed in an abdominal cavity of a patient. Thecontainment bag defines a main portion sized to contain a loose tissuespecimen within the abdominal cavity, a first portion providing anopening sized to receive the loose tissue specimen and arranged toextend from the main portion outside of the patient while the mainportion is disposed within the abdominal cavity, and a second portionarranged to extend from the main portion outside of the patient whilethe main portion is disposed within the abdominal cavity, the secondportion being configured to receive a tissue visualization device. Thetissue containment system further includes a viewing window sealed tothe second portion, the viewing window being configured such that thetissue visualization device can view an interior region of thecontainment bag when the tissue visualization device is disposed in thesecond portion of the containment bag.

Embodiments may include one or more of the following features.

In some embodiments, the main portion, the first portion, and the secondportion are in fluid communication with one another.

In certain embodiments, the main portion and the first portion are influid communication with each other and fluidly isolated from the secondportion.

In some embodiments, the tissue containment system further includes aretainer attached to an external surface of the second portion.

In certain embodiments, the retainer is adjustable from a first extentthat is smaller than a wound within a wall of the abdominal cavity forpassage through the wound to a second extent that is larger than thewound for retaining an end of the second portion outside of the patient.

In some embodiments, a wall of the containment bag is configured tothermally isolate the interior region of the containment bag from theabdominal cavity.

In certain embodiments, the second portion is formed as a sleeve sizedto surround the tissue visualization device.

In some embodiments, the second portion is invertible to provide adouble wall layer around the tissue visualization device.

In certain embodiments, the viewing window is adjustable from a firstposition outside of the patient to a second position within theabdominal cavity while the main portion of the containment bag isdisposed within the abdominal cavity.

In some embodiments, an end of the second portion is positionableoutside of the patient while the main portion of the containment bag isdisposed within the abdominal cavity.

In certain embodiments, the viewing window is positioned along a wall ofthe main portion of the containment bag.

In some embodiments, the second portion defines an opening that ispositionable outside of the patient while the main portion of thecontainment bag is disposed within the abdominal cavity.

In certain embodiments, the second portion and the viewing windowtogether isolate the tissue visualization device from the loose tissuespecimen and from the abdominal cavity.

In some embodiments, the tissue containment system further includes anaccess cap configured to close the opening of the first portion, theaccess cap including an entry port through which a tissue removal devicecan be passed to access an interior region of the containment bag.

In certain embodiments, the tissue containment system further includes awound liner that is configured to surround the first portion of thecontainment bag.

In some embodiments, the access cap is configured to be secured to thewound liner in an airtight manner.

In certain embodiments, the tissue containment system further includes abag introducer configured to introduce the containment bag into theabdominal cavity.

In some embodiments, the entry port for the tissue removal deviceprovides a passageway for the bag introducer.

In certain embodiments, the tissue removal device is a morcellator.

In some embodiments, the tissue visualization device is an endoscope.

In some embodiments, the containment bag has a general shape of akidney.

In certain embodiments, the first and second portions project fromopposite sides of the main portion of the containment bag.

In some embodiments, the closed end of the second portion is a sealedend.

In certain embodiments, the first portion of the containment bag is anopen-ended portion.

In some embodiments, the second portion of the containment bag is aclosed-ended portion.

In certain embodiments, the tissue removal device is a tissue reductiondevice.

In another aspect, a method of containing a loose tissue specimen withinan abdominal cavity of a patient includes introducing a containment baginto the abdominal cavity, moving a loose tissue specimen within theabdominal cavity into a main portion of the containment bag through anopening of a first portion of the containment bag, positioning the firstportion of the containment bag outside of the patient while the mainportion is disposed within the abdominal cavity, positioning a secondportion of the containment bag outside of the patient while the mainportion is disposed within the abdominal cavity, and inserting a tissuevisualization device into the second portion to view an interior regionof the containment bag with the tissue visualization device through aviewing window that provides a seal between an ambient environment andthe interior region of the containment bag.

Embodiments may include one or more of the following features.

In some embodiments, the method further includes inflating thecontainment bag.

In certain embodiments, the method further includes thermally isolatingthe interior region of the containment bag from the abdominal cavity.

In some embodiments, positioning the second portion outside of thepatient includes pulling a retainer ring attached to an external surfaceof the second portion through a wound in wall of the abdominal cavity.

In certain embodiments, the retainer is adjustable from a first extentthat is smaller than the wound to a second extent that is larger thanthe wound.

In some embodiments, the method further includes retaining the secondportion outside of the patient.

In certain embodiments, the method further includes inserting the tissuevisualization device into a sleeve that forms the second portion.

In some embodiments, the method further includes inverting the sleeve toprovide a double wall layer around the tissue visualization device.

In certain embodiments, the method further includes adjusting theviewing window from a first position outside of the patient to a secondposition within the abdominal cavity while the main portion of thecontainment bag is disposed within the abdominal cavity.

In some embodiments, the method further includes positioning an end ofthe second portion outside of the patient while the main portion of thecontainment bag is disposed within the abdominal cavity.

In certain embodiments, the viewing window is positioned along a wall ofthe main portion of the containment bag.

In some embodiments, the method further includes positioning an openingof the second portion outside of the patient while the main portion ofthe containment bag is disposed within the abdominal cavity.

In certain embodiments, the method further includes isolating the tissuevisualization device from the loose tissue specimen and from theabdominal cavity.

In some embodiments, the method further includes closing the opening ofthe first portion with an access cap that includes an entry port for thetissue removal device.

In certain embodiments, the method further includes inserting a woundliner into a wound within a wall of the abdominal cavity and passing thefirst portion of the containment bag through the wound liner.

In some embodiments, the method further includes securing the access capto the wound liner in an airtight manner.

In some embodiments, the method further includes passing a bagintroducer through the entry port of the access cap.

In certain embodiments, the method further includes introducing thecontainment bag into the abdominal cavity.

In some embodiments, the method further includes morcellating the tissuecontained within the main portion of the containment bag.

In certain embodiments, the method further includes viewing the interiorregion of the containment bag with an endoscope.

In some embodiments, the surgical procedure is a laparoscopic procedure.

In another aspect, a tissue containment system includes a bag body thatat least partially defines an interior region configured to contain aloose tissue specimen and that defines an opening sized to receive theloose tissue specimen, the bag body being configured such that a firstportion of the bag body can be disposed in an abdominal cavity of apatient while a second portion of the bag body extends outside of thepatient. The tissue containment system further includes a memberextending from the bag body and defining a channel and a viewing windowthat is at least partially transparent and that provides a seal betweenthe interior region of the bag body and an ambient environment, thechannel of the member being configured to receive a tissue visualizationdevice that can be used to view the interior region of the containmentbag through the viewing window.

In some embodiments, the bag body and the member are in fluidcommunication with each other.

In certain embodiments, the bag body and the member are fluidly isolatedfrom each other.

In some embodiments, the tissue containment system further includes aretainer attached to an external surface of the member.

In some embodiments, the retainer is adjustable from a first extent thatis smaller than a wound within a wall of the abdominal cavity forpassage through the wound to a second extent that is larger than thewound for retaining the member outside of the patient.

In certain embodiments, wherein a wall of the bag body is configured tothermally isolate the interior region of the bag body from the abdominalcavity.

In some embodiments, the member is formed as a sleeve sized to surroundthe tissue visualization device.

In certain embodiments, the member is invertible to provide a doublewall layer around the tissue visualization device.

In some embodiments, the viewing window is adjustable from a firstposition outside of the patient to a second position within theabdominal cavity while the first portion of the bag body is disposedwithin the abdominal cavity.

In some embodiments, an end of the member is positionable outside of thepatient while the first portion of the bag body is disposed within theabdominal cavity.

In certain embodiments, the viewing window is positioned along a wall ofthe first portion of the bag body.

In some embodiments, the member defines an opening that is positionableoutside of the patient while the first portion of the bag body isdisposed within the abdominal cavity.

In certain embodiments, the member and the viewing window togetherisolate the tissue visualization device from the loose tissue specimenand from the abdominal cavity.

In some embodiments, the tissue containment system further includes anaccess cap configured to close the opening of the bag body, the accesscap including an entry port through which a tissue removal device can bepassed to access the interior region of the bag body.

In certain embodiments, the tissue containment system further includes awound liner that is configured to surround the second portion of the bagbody.

In some embodiments, the access cap is configured to be secured to thewound liner in an airtight manner.

In certain embodiments, the tissue containment system further includes abag introducer configured to introduce the bag body into the abdominalcavity.

In some embodiments, the entry port for the tissue removal deviceprovides a passageway for the bag introducer.

In certain embodiments, the tissue removal device is a morcellator.

In some embodiments, the tissue visualization device is an endoscope.

In another aspect, a tissue containment system includes a containmentbag configured to be placed in an abdominal cavity of a patient. Thecontainment bag defines a main portion sized to contain a loose tissuespecimen within the abdominal cavity, a first portion providing anopening sized to receive the loose tissue specimen and arranged toextend from the main portion outside of the patient while the mainportion is disposed within the abdominal cavity, and a second portionarranged to extend from the main portion outside of the patient whilethe main portion is disposed within the abdominal cavity and providing asealable end configured to receive a tissue visualization device at alocation outside of the patient. The tissue containment system furtherincludes a sealable connector attached to the sealable end of the secondportion and through which the tissue visualization device can be passedto view an interior region of the containment bag.

Embodiments may provide one or more of the following advantages.

In some embodiments, the containment bag defines a main portion sized tohold and surround the tissue, an open-ended portion by which the mainportion can be accessed with surgical instruments, and a closed-endedportion by which an interior region of the specimen container can beviewed with a tissue visualization device. The open-ended portion canprovide a single opening (i.e., the only opening) of the containmentbag.

In certain embodiments, the closed-ended portion has a preformed shape(e.g., a tubular shape) that projects from the main portion tofacilitate positioning of the closed-ended portion within the wound. Theclosed-ended portion also defines a position of the viewing window alongthe containment bag such that contact between the viewing window and atissue visualization device provides a tactile indication of anorientation and a position of the containment bag within the abdominalcavity. Because the closed-ended portion is sized and shaped to extendthrough the wound outside of the patient, the closed-ended portion canaccommodate an inverted placement of the viewing window within theinterior region of the containment bag.

In some embodiments, the viewing window has an unobstructed wall (e.g.,without interior seam lines) that is impenetrable to engaginglaparoscopic devices. The viewing window also provides the tissuecontainment system with an access port (e.g., a vision access port) thatis separate from the access cap such that a region in which a tissuevisualization device (e.g., an endoscope or laparoscope) is placed isout of the way of a region that may contain other surgical tools. Theviewing window provides an optically clear barrier between the tissuevisualization device and the interior of the containment bag. Forexample, the inner end region of the viewing window may be the onlyportion of the tissue containment system that separates a distal end ofthe tissue visualization device from the interior region of thecontainment bag. Accordingly, fogging of the tissue visualization devicethat may otherwise occur as a result of exposure to an interior regionof the containment bag is prevented or minimized.

In certain embodiments, the retainer ring serves to fix a position ofthe closed-ended portion within a wound within the abdominal wall. Theretainer ring is a compressible structure that can be compressed to passthrough the wound and that can expand to a nominal configuration uponremoval of an applied compression force to retain the closed-endedportion outside of the patient. Accordingly, the retainer ring locatesthe closed-ended portion of the containment bag with respect to thewound such that the viewing window extends from the abdominal wall foreasy access by a tissue visualization device. The retainer ring may alsobe compressed in a packaging configuration within a bag introducer.

In some embodiments, the tissue visualization device remains isolatedfrom the abdominal cavity when the tissue visualization device isinserted within the viewing window and moved down into the abdominalcavity. Inserted through the wound, the tissue visualization device hassignificant, improved 3D mobility to view the abdominal cavity, ascompared to use with conventional containment bags that require use of atissue visualization device with a trocar to maintain insufflation, butwhich also limits the degrees of freedom of the tissue visualizationdevice. Because the tissue visualization device is withdrawn through theinverted configuration of the closed-ended portion of the containmentbag, the tissue visualization device is isolated from the abdominalcavity and from the abdominal wall and thereby prevented frompotentially contaminating the abdominal cavity. Additionally, since theviewing window provides a closed port of the containment bag, thecontainment bag does not have a second opening that would otherwiserequire an additional procedural step of closing such an opening to sealthe containment bag. Therefore, the configuration of the viewing windowreduces the risk of exposing a patient to a contaminated opening.

In some embodiments, the containment bag provides a degree of thermalinsulation for the interior region of the containment bag within theabdominal cavity, such that the containment bag can be inflated with agas that has a different temperature (e.g., that is significantlywarmer) than a CO₂ insufflation temperature within the abdominal cavity.The isolated, spacious environment of the inflated containment bagincreases control of the morcellation environment. For instance, owingto a separation of the interior region of the containment bag from theabdominal cavity, any potential fogging of the tissue visualizationdevice (e.g., in contact with the viewing window) can be prevented orminimized. Additionally, the constituency and warmer temperature of thegas delivered to the containment bag may provide an internal environmentof the containment bag that is drier than the environment of thesurrounding abdominal cavity, which can aid the start of a desiccationprocess on the tissue and other wet contents within the containment bag.

In certain embodiments, the access cap is constructed to interface withthe open-ended region of the containment bag and the wound liner toclose the opening of the containment bag outside of the abdominal wallof the patient. The access cap includes a cover plate that is sized tocover the opening of the containment bag. A snap-on configuration of thecover plate that is formed to interface directly with the wound linerprovides a relatively simple, easy mechanism for covering the wound.

Other aspects, features, and advantages will be apparent from thedescription, the drawings, and the claims.

DESCRIPTION OF DRAWINGS

FIG. 1 is an exploded perspective view of a tissue containment systeminterfaced with an abdomen of a patient.

FIG. 2 is an exploded side view of a portion of the tissue containmentsystem of FIG. 1 .

FIG. 3 is a side view of a portion of the tissue containment system ofFIG. 1 , shown with an inverted configuration of a containment bag.

FIG. 4 is a perspective view of a wound liner of the tissue containmentsystem of FIG. 1 and the containment bag, including a viewing window.

FIG. 5 is a perspective view of a portion of the tissue containmentsystem of FIG. 1 .

FIG. 6 is a perspective view of an access cap of the tissue containmentsystem of FIG. 1 .

FIG. 7 is a perspective view of a bag introducer of the tissuecontainment system of FIG. 1 .

FIGS. 8-14 illustrate a method of using the tissue containment system ofFIG. 1 during a laparoscopic procedure.

FIG. 15 is a perspective view of a tissue containment system interfacedwith an abdomen of a patient.

FIG. 16 is a perspective view of a tissue containment system interfacedwith an abdomen of a patient, with a closeable end in an openconfiguration.

FIG. 17 is a perspective view of the closeable end of the tissuecontainment system of FIG. 16 in a closed configuration.

DETAILED DESCRIPTION

FIGS. 1 and 2 illustrate a tissue containment system 100 (e.g., amorcellation containment system) that can provide an isolatedenvironment in which a tissue 101 that has been separated from astructure within an abdominal cavity 103 of a patient can be morcellatedor otherwise reduced and removed during a laparoscopic procedure.Example tissues 101 that may be loosed within the abdominal cavity 103and morcellated within the tissue containment system 100 include tissuesthat are suspected of being pathological, but non-malignant, such asuterine fibroids, and endometriotic lesions. In a rare case that atissue 101 proves to be malignant following the laparoscopic procedure,trace parts of the tissue 101 generated by the morcellation process willhave been contained within the tissue containment system 100 and therebyisolated from the abdominal cavity 103. Example structures within theabdominal cavity 103 from which the tissue 101 may be separated includeorgans (e.g., a uterus or an ovary) and other structures. The tissue 101may be separated from the abdominal structure or some other structurewithin the abdominal cavity by severance (e.g., cutting), ablation, orother energy sources (e.g., laser sources, electrocautery sources,harmonic sources, and bimodal energy sources). The tissue containmentsystem 100 is constructed to interface with an abdominal wall 105 of thepatient and is a disposable system that is discarded upon completion ofthe laparoscopic procedure.

The tissue containment system 100 includes a specimen container 102 thatcan be placed within the abdominal cavity 103, an access cap 104 formedto close the specimen container 102 along an external surface of theabdominal wall 105, a wound liner 106 (e.g., a wound protector) by whicha portion of the specimen container 102 can be passed through a wound107 (e.g., an incision) in the abdominal wall 105, and a bag introducer110 by which the specimen container 102 can be placed within theabdominal cavity 103. The various components of the tissue containmentsystem 100 may be provided as a kit of separate components that can beinterfaced with each other and with the patient at the time ofperforming the laparoscopic procedure.

Referring to FIGS. 3 and 4 , the specimen container 102 is generallyshaped like a kidney and includes a containment bag 112, a viewingwindow 114, a retainer ring 108, a drawstring tether 116, and a pulltether 118. The containment bag 112 defines a main portion 120 (e.g., acentral, largest volumetric portion) sized to hold and surround thetissue 101, an open-ended portion 122 by which the main portion 120 canbe accessed with surgical instruments, and a closed-ended portion 124 bywhich an interior region of the specimen container 102 can be viewedwith a tissue visualization device (e.g., an endoscope or a disposablevisualization device). The main portion 120, the open-ended portion 122,and the closed-ended portion 124 are in fluid communication with oneanother. The open-ended portion 122 provides a single opening (i.e., thesole opening) 26 of the specimen container 102. The open-ended portion122 is sized and shaped to receive the tissue 101 within the abdominalcavity 103 during one stage of the procedure and to interface with theaccess cap 104 along the external surface of the abdominal wall 105during a later stage of the procedure. The opening 126 of the specimencontainer 102 is lined with the drawstring tether 116, by which theopening 126 can be closed (e.g., cinched) upon completion of thelaparoscopic procedure. The drawstring tether 116 can also be used topull the open-ended portion 122 up through the wound liner 106 and outof the patient so that a position of the open-ended portion 122 of thecontainment bag 112 can be fixed between the access cap 104 and thewound liner 106, as will be discussed in more detail below with respectto FIGS. 8-14 .

The retainer ring 108 surrounds the closed-ended portion 124 of thecontainment bag 112 and serves to fix a position of the closed-endedportion 124 within a wound 109 (e.g., an incision) within the abdominalwall 105. The retainer ring 108 is a compressible structure that can becompressed to allow it to be passed through the wound 109 and that canexpand to a nominal configuration (e.g., as shown in FIGS. 1-5 ) uponremoval of an applied compression force. The expanded or nominalconfiguration of the retainer ring 108 can help to ensure that theretainer ring 108 remains outside the patient during tissuemorcellation.

The closed-ended portion 124 has a preformed shape that projects fromthe main portion 120 to facilitate positioning of the closed-endedportion 124 within the wound 109. The closed-ended portion 124 alsodefines a position of the viewing window 114 along the containment bag112 such that contact between the viewing window 114 and a tissuevisualization device provides a tactile indication of an orientation anda position of the containment bag 112 within the abdominal cavity 103.Because the closed-ended portion 124 is sized and shaped to extendthrough the wound 109 outside of the patient, the closed-ended portion124 can accommodate an inverted placement of the viewing window 114within the interior region of the specimen container 102, as shown inFIG. 3 . The viewing window 114 is clear, has a U shaped cross-section,and is sized and shaped to receive a distal end of a tissuevisualization device directly (e.g., without a trocar) for viewing theinterior region of the specimen container 102. The viewing window 114 isa rigid structure (e.g., as compared to the containment bag 112) thathas an unobstructed wall (e.g., without interior seam lines) that isimpenetrable to engaging laparoscopic devices during normal use. Theviewing window 114 provides the tissue containment system 100 with anaccess port (e.g., a vision access port) that is separate from theaccess cap 104 such that a region in which a tissue visualization deviceis placed is out of the way of a region that may contain other surgicaltools. The pull tether 118 is attached to the closed-ended portion 124and can be used to pull the closed-ended portion 124 (e.g., includingthe retainer ring 108) through the wound 109 and outside of the patient.

The containment bag 112 is a compliant structure that can be flattened,rolled, and/or folded in a packaging configuration (e.g., within the bagintroducer 110), inflated to achieve a predetermined, expanded shape(e.g., the general shape of a kidney, as shown in FIGS. 1-4 ) formorcellation of the tissue 101 therein, and allowed to deflate toachieve a less formed, collapsed configuration for removal of thespecimen container 102 from the abdominal cavity 103 through the woundliner 106, as will be discussed in more detail below with respect toFIGS. 8-14 . The containment bag 112 is impermeable to liquids and gasessuch that once the open end 126 is positioned outside of the abdominalwall 105, the tissue 101 contained therein is isolated from theabdominal cavity 103 of the patient. The impermeable character of thecontainment bag 112 further prevents leakage of an inflation gas withinthe containment bag 112 to the abdominal cavity 103, as will bediscussed in more detail below with respect to FIGS. 8-14 .

The containment bag 112 is relatively puncture resistant, such that anypotential of the containment bag 112 being pierced by a sharp edge ofthe morcellator or another laparoscopic device is minimized should thesharp edge inadvertently contact the containment bag 112. Furthermore,the containment bag 112 defines an interior region that is separatedfrom (e.g., physically and, to some degree, thermally) the abdominalcavity 103, such that the containment bag 112 can be inflated with a gas(e.g., filtered air) of a temperature that is different (e.g., warmer)than a temperature of CO₂ insufflation gas within the abdominal cavity103. For instance, in some examples, the abdominal cavity 103 may beinsufflated with medical grade CO₂ at an ambient room temperature in arange of about 19° C. to about 21° C., and the containment bag 112 maybe inflated with air at a temperature in a range of about 19° C. up totypical body temperature (e.g., about 37° C.). The containment bag 112is translucent such that although the containment bag 112 is notoptically clear, some light can pass through the containment bag 112,which may facilitate imaging of the interior region of the containmentbag 112.

The containment bag 112 is made of one or more materials that arecompliant, impermeable, puncture resistant, and translucent, asdescribed above. Example materials from which the containment bag 112can be made include polyurethane, ballistic nylon, and ripstop nylon.The containment bag 112 may be formed from one or more sheets ofmaterial that are sealed along one or more peripheral edges, excludingthe opening 126. Edges of the one or more sheets of material may besealed via heat stake, gluing, or ultrasonic attachment.

In an inflated state, the containment bag 112 provides a large, safeworking zone in which the tissue 101 can be morcellated within thecontainment bag 112 at a location remote (e.g., spaced apart) fromorgans in the abdominal cavity 103. The containment bag 112 is alsosmall enough to avoid significant infolding or double layering of thecontainment bag 112 within the abdominal cavity 103. The containment bag112 can have a volume that is greater than a nominal volume of anabdominal cavity in which it is deployed. For example, an abdominalcavity may have a nominal volume in a range of about 4 L to about 6 L.However, in a fully inflated state (and positioned within a patient, asshown in FIG. 1 ), the containment bag 112 typically has a volume ofabout 6 L to about 8 L, and the main portion 120 of the containment bag112 typically has a volume of about 5.5 L to about 7.5 L.

The main portion 120 typically has a nominal (e.g., collapsed,flattened) length of about 30 cm to about 40 cm (e.g., about 35 cm) anda nominal width of about 18 cm to about 24 cm (e.g., about 21 cm). In aninflated state, the open-ended portion 122 is generally cylindricallyshaped, and the open end 126 typically has a diameter of about 12 cm toabout 24 cm (e.g., about 18 cm). The open-ended portion 122 typicallyhas a nominal length of about 12 cm to about 20 cm (e.g., about 16 cm)and a nominal width of about 12 cm to about 15 cm (e.g., about 14 cm).In an inflated state, the closed-ended portion 124 has a generallytubular shape. The closed-ended portion 124 typically has a nominallength of about 20 cm to about 50 cm (e.g., about 35 cm), an interior(e.g., adjacent the main portion 120) nominal width of about 6 cm toabout 10 cm (e.g., about 8 cm), and a peripheral nominal width (e.g.,adjacent a rim 128 of the viewing window 114) of about 1.0 cm to about1.5 cm (e.g., about 1.2 cm). The closed-ended portion 124 typicallyextends about 20 cm to about 45 cm outside of the abdominal wall 105during a laparoscopic procedure.

The tethers 116, 118 are typically made of one or more materialsincluding nylon, tetrafluoroethylene (TFE), and flashspun high-densitypolyethylene fibers. The tethers 116, 118 typically have a length ofabout 30 cm to about 50 cm (e.g., about 40 cm). The retainer ring 108has a nominal internal diameter that is two to four times larger than alength of the wound 109. For example, the wound 109 typically has alength in a range of about 20 mm to about 25 mm, and the retainer ring108 typically has a nominal internal diameter of about 3.0 cm to about3.5 cm (e.g., about 3.0 cm). The retainer ring 108 is attached to theclosed-ended portion 124 of the containment bag 112 via heat sealing,glue, or ultrasonic attachment. The retainer ring 108 may be made of oneor more soft, expandable or compressible materials that allow theretainer ring 108 to pass through the wound 109, such as foam,polypropylene, TPE, polyethylene, or santoprene.

The viewing window 114 provides an optically clear barrier between thetissue visualization device and the containment bag 112. The viewingwindow 114 is attached along the rim 128 to the closed-ended portion 124of the containment bag 112 in a manner such that an inner end region 130of the viewing window 114 is free from (e.g., not attached to) thecontainment bag 112. Accordingly, the inner end region 130 of theviewing window 114 is the only portion of the tissue containment system100 that may separate a distal end of the tissue visualization devicefrom the interior region of the containment bag 112. The viewing window114 is typically attached to the closed-ended portion 124 of thecontainment bag 112 via an airtight seal (e.g., a hermetic seal), suchas a heat seal, an ultrasonic weld, or one or more mechanical means(e.g., an o-ring, a nut, etc.). In this manner, the viewing window 114provides a seal between an interior region of the containment bag 112and an ambient room environment in which the laparoscopic procedure isperformed. The viewing window 114 is typically made of one or more clearplastic materials, such as polycarbonate or other optically clearmaterials. The viewing window 114 typically has a length of about 2.0 cmto about 4.0 cm (e.g., about 3.0 cm) and an internal rim diameter ofabout 1.0 cm to about 1.5 cm (e.g., about 1.2 cm).

Still referring to FIGS. 3 and 4 , the wound liner 106 provides anextended passageway through the wound 107 and an enlarged exit regionnear the internal surface of the abdominal wall 105 for the open-endedportion 122 of the containment bag 112 and thereby protects the wound107 from mechanical wear of the containment bag 112 and potential tissuecontamination that may be present thereon near the opening 126 of thecontainment bag 112. The wound liner 106 is generally cylindricallyshaped and includes a collapsible wall 132 that can be passed though thewound 107, a port access ring 134 attached to one end of the collapsiblewall 132, and an anchoring ring 136 attached to an opposite end of thecollapsible wall 132.

The collapsible wall 132 is a compliant structure that can be collapsedfor insertion of the anchoring ring 136 through the wound 107 and thatcan be extended from the collapsed configuration to position the portaccess ring 134 against the external surface of the abdominal wall 105with the anchoring ring 136 positioned within the abdominal cavity 103(e.g. abutting an internal surface of the abdominal wall 105 or hangingspaced apart from the internal surface of the abdominal wall 105). Thecollapsible wall 132 may have the same material formulation as thecontainment bag 112 and therefore may be impermeable, punctureresistant, and translucent, as discussed above with respect to thecontainment bag 112. The collapsible wall 132 typically has a maximumextended length of about 12 cm to about 16 cm (e.g., about 14 cm) and aninternal diameter of about 8 cm to about 12 cm (e.g., about 10 cm). Thecollapsible wall 132 is typically sealed to itself along its endssnuggly about the port access ring 134 and the anchoring ring 136.

The port access ring 134 may have a rectangular (e.g., square)cross-sectional shape and has a flexibility that allows the port accessring 134 to be snap fit into engagement with the access cap 104, as willbe discussed in more detail below with respect to FIGS. 8-14 . Theanchoring ring 136 may have a circular cross-sectional shape and has aflexibility that allows the anchoring ring 136 to be squeezed forinserting through the wound 107, as will be discussed in more detailbelow with respect to FIGS. 8-14 . The port access ring 134 and theanchoring ring 136 typically have an internal diameter that is aboutequal to the internal diameter of the collapsible wall 132.

Referring to FIGS. 5 and 6 , the access cap 104 is constructed tointerface with the open-ended portion 122 of the containment bag 112 andthe wound liner 106 to close the opening 126 of the containment bag 112outside of the abdominal wall 105 of the patient. The access cap 104includes a cover plate 138 that is sized to cover the opening 126 of thecontainment bag 112. The cover plate 138 defines a flat upper wall 156,a peripheral flange 140 into which the port access ring 134 of the woundliner 106 can be snapped fitted, an insufflation port 142 for connectionto a gas line, a morcellation port 144 that allows passage of amorcellator shaft and the bag introducer 110, and two working ports 146that allow passage of other laparoscopic tools, such as a dissector, agrasper, an irrigation line, a scope/camera. The access cap 104 furtherincludes valves 148, 150 and a quick connect fitting 152 that arerespectively secured to the morcellation port 144, the working ports146, and the insufflation port 142. The valves 148, 150 (e.g.,cross-slit valves, duck bill valves, or other mechanically activatedvalves) can secure instruments passing therethrough while allowingpassage of only minimal gas leakage out of the containment bag 112. Thequick connect fitting 152 can secure a gas line (e.g., a dual-lumen gasline) that can deliver and/or withdraw gas from the containment bag 112.For example, such a gas line may include a first lumen that delivers aninflation gas (e.g., medical grade CO₂) into the containment bag 112 anda second lumen that withdraws smoke (e.g., produced during powermorcellation) out of the containment bag 112.

The cover plate 138 is generally circular and has a diameter that isthree to four times larger than a length of the wound 107. For example,the wound 107 typically has a length in a range of about 20 mm to about25 mm, and the cover plate 138 typically has a diameter of about 7 cm toabout 12 cm (e.g., about 10 cm). The peripheral flange 140 of the coverplate 138 is a lipped structure that forms a receptacle and definesmultiple notches 154 that facilitate snap fitting of the port accessring 134 into the peripheral flange 140. A snap-on configuration of thecover plate 138 that is formed to interface directly with the woundliner 106 provides a relatively simple, easy mechanism for covering thewound 109, as compared to certain conventional caps. The cover plate 138may be a rigid, flexible, or semi-rigid structure that is typically madeof one or more materials, such as santoprene, EPDM (ethylene propylenediene monomer), polypropylene, nylon, polycarbonate, polyethylene,acrylonitrile butadiene styrene (ABS), polyetherimide (PEI), or otherengineering injection medical grade resins. The cover plate 138 may bemanufactured using one or more techniques, such as machining orinjection molding. The valves 148, 150 are typically made of one or moreflexible materials, such as silicone. The quick connect fitting 152 is arigid connection that is typically made of one or more sufficientlyrigid materials.

Referring to FIG. 7 , the bag introducer 110 includes a shaft 158 thatis sized to accommodate the specimen container 102, including thecontainment bag 112 and the viewing window 114 and the retainer ring 108(omitted from FIG. 7 for clarity) in a rolled or folded configurationand a slidable button 160 by which the specimen container 102 can beejected from the shaft 158. The shaft 158 defines a slot 162 along whichthe slidable button 160 can be translated distally to move the specimencontainer 102 and a notch 164 that can receive the slidable button 160to terminate distal movement of the slidable button 160. The shaft 158also defines a distal opening 166 from which the specimen container 102can exit the shaft 158 as the slidable button 160 is moved distallyalong the shaft 158. The bag introducer 110 can be passed through themorcellation port 144 of the access cap 104 for insertion and deploymentof the specimen container 102. The bag introducer 110 typically has atotal length of about 15 cm to about 25 cm (e.g., about 20 cm) and aninternal diameter of about 2 cm to about 3 cm (e.g., about 2.5 cm). Thebag introducer 110 is a rigid structure that is typically made of one ormore materials, such as polycarbonate or ABS.

FIGS. 8-14 illustrate a method of containing (e.g., isolating) thetissue 101 using the tissue containment system 100 during a laparoscopicprocedure. Referring to FIG. 8 , the wound liner 106 is squeezed to acompact configuration and inserted within the wound 107. The anchoringring 136 of the wound liner 106 is positioned within the abdominalcavity 103 and allowed to relax to a nominal state. The port access ring134 of the wound liner 106 remains outside of the abdominal cavity 103and is allowed to rest against the external surface of the abdominalwall 105 such that an entire extent of the wound 107 is protected by thewound liner 106.

Referring to FIG. 9 , the access cap 104 is snap fitted to the portaccess ring 134 of the wound liner 106 to seal the abdominal cavity 103.A gas line is connected to the quick connect fitting 152 at theinsufflation port 142 of the access cap 104, and the abdominal cavity103 is insufflated with a gas (e.g., medical grade CO₂) delivered from adelivery lumen of the gas line. The CO₂ gas temperature typically has anambient room temperature of about 19° C. to about 21° C., which isrelatively cold as compared to typical body temperature of about 37° C.The insufflation expands a volume of the abdominal cavity 103 to allowthe specimen container 102 to be introduced into and deployed within theabdominal cavity 103.

Referring to FIG. 10 , the gas line is removed, and the bag introducer110, loaded with the specimen container 102, is inserted into themorcellation port 144 of the access cap 104 until at least the distalopening 166 of the shaft 158 is positioned within the wound liner 106.The slidable button 160 is translated distally until the specimencontainer 102 is ejected from the shaft 158 and delivered to theabdominal cavity 103. The bag introducer 110 is removed (e.g.,withdrawn) from the morcellation port 144, and one or more laparoscopicinstruments (e.g., a grasper, clamps, or a robotic grasper) are insertedinto the abdominal cavity 103 via the working ports 146 of the accesscap 104.

Referring to FIG. 11 , the specimen container 102 is deployed (e.g., thecontainment bag 112 is unrolled, unfolded, and/or spread out), and thepull tether 118 is pulled through the wound 109 using the laparoscopicinstruments. The pull tether 118 may be visualized by an endoscopepositioned within a wound of the abdominal cavity 103 during an earlierstage of the surgery. The pull tether 118 is pulled until the retainerring 108 of the specimen container 102 is positioned outside of theabdominal wall 105. Accordingly, the retainer ring 108 locates theclosed-ended portion 124 of the containment bag 112 with respect to thewound 109 such that the viewing window 114 extends from the abdominalwall 105 for easy access by a tissue visualization device.

The tissue visualization device is inserted within the viewing window114 and is moved down into the abdominal cavity 103 for visualization ina manner such that, due to a position of the retainer ring 108, theclosed-ended portion 124 remains within the wound 109 in an invertedconfiguration, and the tissue visualization device remains isolated fromthe abdominal cavity 103. Inserted through the wound 109, the tissuevisualization device has significant, improved 3D mobility to view theabdominal cavity 103, as compared to use with conventional containmentbags that require use of a tissue visualization device with a trocar tomaintain insufflation. Visualized by the tissue visualization device,the tissue 101 is placed within the containment bag 112 via the opening126 of the containment bag 112. The drawstring tether 116 is then pulledinto the wound liner 106 using the laparoscopic instruments. With thedrawstring tether 116 disposed within the wound liner 106, theopen-ended portion 122 of the containment bag 112 is positioned near theabdominal wall 105 for easy access. The access cap 104 is removed fromthe wound liner 106, and the open-ended portion 122 of the containmentbag 112 is quickly pulled up through the wound liner 106 until theopen-ended portion 122 overlays the port access ring 134 of the woundliner 106. The open-ended portion 122 is pulled quickly through thewound liner 106 to minimize the loss of pneumoperitoneum (e.g.,abdominal gas pressure).

Referring to FIG. 12 , the access cap 104 (e.g., with the gas line stillattached to the quick connect fitting 152) is quickly reattached to theport access ring 134 (e.g., to minimize the loss of pneumoperitoneum)with the open-ended portion 122 of the containment bag 112 fixed (e.g.,sandwiched) between the access cap 104 and the port access ring 134. Thecontainment bag 112 is inflated (e.g., with filtered air or medicalgrade CO₂) via the delivery lumen of the gas line to make room in thecontainment bag 112 for insertion of a morcellator (e.g., a powermorcellator). For example, the gas exerts forces on an internal surfaceof the containment bag 112 in a direction normal to the internal surfaceto expand (e.g., inflate) the containment bag 112 to create a workingspace needed for a morcellation process.

The isolated, spacious environment of the inflated containment bag 112increases control of the morcellation environment. For instance, owingto heat transfer properties of the material of the containment bag 112,the temperature of the gas delivered to the containment bag 112 can beabout the same (e.g., when the gas is medical grade CO₂) or warmer(e.g., when the gas is filtered air) than that of the abdominalinsufflation gas such that any potential fogging of the tissuevisualization device (e.g., in contact with the viewing window 114) isprevented or minimized. The temperature of CO₂ delivered to thecontainment bag 112 is typically in a range of about 19° C. to about 21°C., whereas the temperature of filtered air delivered to the containmentbag 112 is typically in a range of about 19° C. to about 37° C. In someexamples, the constituency and warmer temperature of filtered airdelivered to the containment bag 112 may provide an internal environmentof the containment bag 112 that is drier than the environment of thesurrounding abdominal cavity 103, which can aid the start of adesiccation process on the tissue 101 and other wet contents within thecontainment bag 112. Isolating drier filtered air within the containmentbag 112 from the abdominal cavity 103 may be advantageous, as peritonealdrying has been linked to post-operative pain and to evaporativecooling, which may decrease core temperature, increase intra-operativehypothermia, and promote adhesion formation. In some examples, thefiltered air delivered to the containment bag 112 may be warmer andhumidified. To the extent that any heat from filtered air within thecontainment bag 112 is transferred through the containment bag 112 tothe abdominal cavity 103, such heat will tend to minimize undesirableeffects associated with abdominal insufflation CO₂ that is colder thanthe body temperature.

Referring to FIG. 13 , once the containment bag 112 is inflated, amorcellator 111 is inserted into the containment bag 112 via themorcellation port 144 of the access cap 104 and used to morcellate thetissue 101. The morcellator 111 may be any suitable, commerciallyavailable tissue morcellator. The morcellation process is visualizedwith the tissue visualization device that is engaged with the viewingwindow 114 interior to the abdominal cavity 103, while the tissuevisualization device is isolated from the abdominal cavity 103 andisolated from an interior region of the containment bag 112. During themorcellation process, the tissue 101 is ground into small pieces andwithdrawn from the containment bag 112 (e.g., suctioned through themorcellator 111). Any trace amounts or particles of tissue generatedduring the morcellation process, but not suctioned through morcellator111, are contained within the containment bag 112 and thus preventedfrom contacting (e.g., potentially contaminating) the abdominal cavity103.

Referring to FIG. 14 , upon completion of the morcellation process, themorcellator 111 is withdrawn from the morcellator port 144, and anyother laparoscopic instruments that may still be disposed within thecontainment bag 112 are withdrawn from the working ports 146. After themorcellator 111 and laparoscopic instruments are removed, the tissuevisualization device is removed from the wound 109. Because the tissuevisualization device is withdrawn through the inverted configuration ofthe closed-ended portion 124 of the containment bag 112, the tissuevisualization device is isolated from the abdominal cavity 103 and fromthe abdominal wall 105 and thereby prevented from potentiallycontaminating the abdominal cavity 103. Additionally, since the viewingwindow 114 provides a closed port of the containment bag 112, thecontainment bag 112 does not have a second opening that would otherwiseexist in a conventional containment bag and therefore eliminates theneed for an additional procedural step to close such an opening andeliminates a potential of exposing a patient to a contaminated opening.Once the tissue visualization device is removed from the patient, theretainer ring 108 is then pushed down into the abdominal cavity 103through the wound 109. The access cap 104 is removed from the woundliner 106, and the open-ended portion 122 of the containment bag 112 ispulled through the wound liner 106 to remove the containment bag 112from the abdominal cavity 103. The containment bag 112 can be knottedabout itself, tied with the drawstring tether 116, or otherwise closedat the open-ended portion 122 and discarded.

While certain embodiments have been described above, other embodimentsare possible. For example, while the tissue containment system 100 hasbeen described and illustrated as including the viewing window 114disposed along a tip of the closed-ended portion 124 of the containmentbag 112, in some embodiments, a tissue containment system that isotherwise substantially similar in construction and function to thetissue containment system 100 includes a viewing window that is disposedalong a main portion of a containment bag. Referring to FIG. 15 , atissue containment system 200 includes a specimen container 202 that canbe placed within the abdominal cavity 103 and the access cap 104, thewound liner 106, and the bag introducer 110 of the tissue containmentsystem 100. As with the tissue containment system 100, the variouscomponents of the tissue containment system 200 can be provided as a kitof separate components that can be interfaced with each other and withthe patient at the time of performing the laparoscopic procedure.

The specimen container 202 is shaped similarly to the specimen container102 and includes a containment bag 212 and a viewing window 214. Thespecimen container 202 also includes the retainer ring 108, thedrawstring tether 116, and the pull tether 118 of the specimen container102. The containment bag 212 defines the main portion 120 and theopen-ended portion 122 of the containment bag 112 and a closed-endedportion 224 by which an interior region of the specimen container 202can be viewed with a tissue visualization device. The main portion 120and the open-ended portion 122 are in fluid communication with eachother, but fluidly isolated from the closed-ended portion 224. Theopen-ended portion 122 provides a single opening 226 of the specimencontainer 202 that can be manipulated by the drawstring tether 116, asdiscussed above with respect to the specimen containment system 100. Theretainer ring 108 surrounds the closed-ended portion 224 of thecontainment bag 212 and serves to fix a position of the closed-endedportion 224 within the wound 109 within the abdominal wall 105.

The closed-ended portion 224 is shaped similarly to the closed-endedportion 124 of the containment bag 112 and accordingly projects from themain portion 120 to facilitate positioning of the closed-ended portion224 within the wound 109. A sealed interface between the closed-endedportion 224 and the main portion 120 defines a position of the viewingwindow 214 along the containment bag 212 such that contact between theviewing window 214 and a tissue visualization device provides a tactileindication of an orientation and a position of the containment bag 212within the abdominal cavity 103. In this manner, the viewing window 214further provides a closed end of the closed-ended portion 224 that isarranged to remain inside of the abdominal cavity 103 duringmorcellation of the tissue 101. The closed-ended portion 224 defines anopening 268 in a direction opposite the viewing window 214 to provideaccess to a tissue visualization device. The viewing window 214 is anoptically clear, flexible wall that is sized and shaped to be contactedacross its area by a distal end of a tissue visualization device forviewing the interior region of the specimen container 202. The viewingwindow 214 is stiffer and less compliant than the containment bag 212and provides an unobstructed wall (e.g., without interior seam lines)that is impenetrable to engaging laparoscopic devices. The viewingwindow 214 provides the tissue containment system 200 with an accessport (e.g., a vision access port) that is separate from the access cap104 such that a region in which a tissue visualization device is placedis out of the way of a region that may contain other surgical tools.

The containment bag 212 has the same material formulation andconstruction of the containment bag 112 and is therefore compliant,impermeable, relatively puncture resistant, and translucent, asdiscussed above with respect to the containment bag 112. Theclosed-ended portion 224 of the containment bag 212 has the same sizeand the shape as those of the closed-ended portion 124 of thecontainment bag 112. Accordingly, the containment bag 212 provides alarge, safe working zone in which the tissue 101 can be morcellatedwithin the containment bag 212 at a location remote (e.g., spaced apart)from organs in the abdominal cavity 103, while being small enough toavoid significant infolding or double layering of the containment bag212 within the abdominal cavity 103.

The viewing window 214 provides an optically clear barrier between thetissue visualization device and the containment bag 212. Accordingly,the viewing window 214 is the only portion of the tissue containmentsystem 200 that may separate a distal end of the tissue visualizationdevice from the interior region of the containment bag 212. The viewingwindow 214 is typically attached to the main portion 120 of thecontainment bag 212 via a heat seal, an ultrasonic weld, or glue. Theviewing window 214 is typically made of one or more clear plasticmaterials, such as polycarbonate or other medical grade clearengineering resins. The viewing window 214 may have a round (e.g.,circular) or non-round shape and typically has a total cross-sectionalarea of about 7 cm² to about 10 cm² (e.g., about 8 cm²).

The tissue containment system 200 can be used similarly to the tissuecontainment system 100 to contain a tissue during a laparoscopicprocedure, as discussed above with respect to FIGS. 8-14 , except that atissue visualization device is inserted through the opening 268 of theclosed-ended portion 224 to access the viewing window 214 instead ofbeing inserted into a viewing window constructed like that of theviewing window 114.

In some embodiments, a tissue containment system that is otherwisesubstantially similar in construction and function to the tissuecontainment system 200 may include a containment bag that is closed off(e.g., fluidly isolated) from the closed-ended portion 224, except thatthe containment bag is optically clear (e.g., transparent) and does notinclude a separate viewing window (e.g., the viewing window 214). Forexample, such a containment bag can include an open-ended portion, aclosed-ended portion, and a main portion that are similar inconstruction and function to the respective portions of the containmentbag, 212, except that the bag is optically clear and the main portiondoes not include the opening defined by the viewing window 214. In otherwords, the wall (e.g., sheet material) of the main portion of thecontainment bag extends across an area to which the closed-ended portionis sealed (e.g., an interior end of the closed-ended portion), such thatthe containment bag is simply formed as an optically clear (e.g.,transparent) bag that defines a single opening (e.g., like the opening126) along one side and that includes a sleeve (e.g., like theclosed-ended portion 224) extending therefrom along a second side. Atissue containment system including such a containment bag can be usedsimilarly to the tissue containment system 200 to contain a tissueduring a laparoscopic procedure.

While the tissue containment systems 100, 200 have been described andillustrated as including the viewing windows 114, 214 that provideclosed endoscopic access ports that isolate the tissue visualizationdevice from the interior regions of the containment bags 112, 212, insome embodiments, a tissue containment system that is otherwisesubstantially similar in construction to either of the tissuecontainment systems 100, 200 includes an open endoscopic access port.For example, as shown in FIGS. 16 and 17 , a tissue containment system300 includes a specimen container 302 that can be placed within theabdominal cavity 103 and the access cap 104, the wound liner 106, andthe bag introducer 110 of the tissue containment system 100. As with thetissue containment system 100, the various components of the tissuecontainment system 300 can be provided as a kit of separate componentsthat can be interfaced with each other and with the patient at the timeof performing the laparoscopic procedure.

The specimen container 302 is shaped similarly to the specimen container102 and includes a containment bag 312 and a sealable connector 314(e.g., a male/female connection mechanism, such as a quick non-spilldisconnection). The specimen container 302 also includes the retainerring 108, the drawstring tether 116, and the pull tether 118 of thespecimen container 102. The containment bag 312 includes the mainportion 120 and the open-ended portion 122 of the containment bag 112,and a closeable end portion 324 by which an interior region of thespecimen container 302 can be viewed with a tissue visualization device.The main portion 120, the open-ended portion 122, and the closeable endportion 324 are in fluid communication with one another. The open-endedportion 122 provides an opening 326 of the specimen container 302 thatcan be manipulated by the drawstring tether 116, as discussed above withrespect to the specimen containment system 100. The retainer ring 108surrounds the closeable end portion 324 of the containment bag 312 andserves to fix a position of the closeable end portion 324 within thewound 109 within the abdominal wall 105.

The closeable end portion 324 is shaped similarly to the closed-endedportion 124 of the containment bag 112 and accordingly projects from themain portion 120 to facilitate positioning of the closeable end portion324 within the wound 109. The closeable end portion 324 also defines aposition of the sealable connector 314 along the containment bag 312 anda cutting plane 368 located just above (e.g., proximal to) the sealedconnector 314 and defining a tip 328 of the closeable end portion 324.Because the closeable end portion 324 is sized and shaped to extendthrough the wound 109 outside of the patient, the closeable end portion324 can accommodate an inverted placement of the sealed connector 314within the retainer ring 108. The pull tether 118 is attached to thecloseable end portion 324 and can be used to pull the closeable endportion 324 (e.g., including the retainer ring 108) through the wound109 and out of the patient.

The sealable connector 314 includes a female connector 370 that issecured to a wall of the closeable end portion 324 and a complementarymale connector 372 that is attached to the closeable end portion 324 bya tether 374. Once the tip 328 of the closeable end portion 324 is cutoff, the male connector 372 is accessible and can be removed from thefemale connector 370. The female connector 370 is sized to allow passageof a distal end of a tissue visualization device for viewing theinterior region of the specimen container 302. The sealable connector314 provides the tissue containment system 300 with an access port(e.g., a vision access port) that is separate from the access cap 104such that a region in which a tissue visualization device is placed isout of the way of a region that may contain other surgical tools.Following visualization of the interior region of the containment bag312 with the tissue visualization device, the tissue visualizationdevice can be removed from the female connector 370, and the maleconnector 372, still tethered to the containment bag 312, can bereattached to the female connector 370 to seal the containment bag 312.

The containment bag 312 has the same material formulation andconstruction of the containment bag 112 and is therefore compliant,impermeable, relatively puncture resistant, and translucent, asdiscussed above with respect to the containment bag 112. The closeableend portion 324 of the containment bag 312 generally has the same sizeand the same shape as those of the closed-ended portion 124 of thecontainment bag 112. Accordingly, the containment bag 312 provides alarge, safe working zone in which the tissue 101 can be morcellatedwithin the containment bag 312 at a location remote (e.g., spaced apart)from organs in the abdominal cavity 103, while being small enough toavoid significant infolding or double layering of the containment bag312 within the abdominal cavity 103.

The sealable connector 314 is typically attached to the closeable endportion 324 of the containment bag 312 via a heat seal, an ultrasonicweld, or one or more mechanical means (e.g., an o-ring, a nut, etc.).The sealable connector 314 is typically made of one or more materials,such as polycarbonate or other materials. The female connector 370 mayhave an internal diameter of about 0.7 cm to about 1.0 cm (e.g., about0.8 cm²) to allow passage of a tissue visualization device.

The tissue containment system 300 can be used similarly to the tissuecontainment system 100 to contain a tissue during a laparoscopicprocedure, as discussed above with respect to FIGS. 8-14 , except thatthe tip 328 of the closed-ended portion is cut off and the maleconnector 372 is removed to allow insertion of a tissue visualizationdevice through the female connector 370 to view the interior region ofthe containment bag 312 directly instead of viewing the interior regionthrough a viewing window constructed like that of the viewing windows114, 214.

While the tissue containment systems 100, 200, 300 have been describedand illustrated as being used with a tissue morcellator, in someimplementations, the tissue containment systems 100, 200, 300 may beused with another type of tissue removal, reduction, and/or manipulationdevice, such as a scalpel, an electrosurgical scalpel, or a vacuum(e.g., suction) device.

While the containment bags 112, 212, 312 of the tissue containmentsystems 100, 200, 300 have been described as translucent, in someembodiments, a tissue containment system that is otherwise substantiallysimilar in construction and function to any of the tissue containmentsystems 100, 200, 300 can include a containment bag that is opticallyclear (e.g., transparent) to further facilitate imaging of an interiorregion of the containment bag with a tissue visualization device.

While the tissue containment systems 100, 200, 300 have been describedand illustrated as having certain sizes, defining certain volumes, andhaving certain shapes, in some embodiments, a tissue containment systemthat is otherwise substantially similar in construction and function toany of the tissue containment systems 100, 200, 300 can have differentsizes, volumes, and/or shapes. In some examples, a tissue containmentsystem can include a containment bag and/or other components that aresized particularly for child patients (e.g., a pediatric tissuecontainment system), adult patients, patients within a particular agerange, or patients with particular medical conditions.

Additionally, other embodiments and implementations are within the scopeof the following claims.

What is claimed is:
 1. A tissue containment system, comprising: a bagbody configured to be placed in an abdominal cavity of a patient anddefining an interior region configured to contain a loose tissuespecimen, the bag body further defining: a main portion sized toaccommodate the loose tissue specimen, an open-ended portion defining anopening sized to receive the loose tissue specimen and arranged toextend from the main portion outside of the patient while the mainportion is disposed in the abdominal cavity, and an invertible portionarranged to extend from the main portion outside of the patient whilethe main portion is disposed within the abdominal cavity, the invertibleportion being invertible to form a double wall layer that is sized toaccommodate a tissue visualization device; and a viewing window sealedto an end of the invertible portion that is opposite to the main portionsuch that the viewing window is positionable outside of the patientwhile the main portion is disposed within the abdominal cavity, theviewing window being configured to receive the tissue visualizationdevice for viewing the interior region of the bag body when theinvertible portion is inverted to form the double wall layer around thetissue visualization device within the patient.
 2. The tissuecontainment system of claim 1, further comprising a retainer attached tothe invertible portion.
 3. The tissue containment system of claim 2,wherein the retainer is adjustable from a first extent that is smallerthan a wound within a wall of the abdominal cavity for passage throughthe wound to a second extent that is larger than the wound for retainingthe invertible portion outside of the patient.
 4. The tissue containmentsystem of claim 1, wherein a wall of the bag body is configured tothermally isolate the interior region of the bag body from the abdominalcavity.
 5. The tissue containment system of claim 1, wherein theinvertible portion of the bag body and the viewing window togetherisolate the tissue visualization device from the loose tissue specimenand from the abdominal cavity.
 6. The tissue containment system of claim5, further comprising an access cap configured to close the opening ofthe open-ended portion of the bag body.
 7. The tissue containment systemof claim 6, further comprising a wound liner that is configured tosurround the open-ended portion of the bag body.
 8. The tissuecontainment system of claim 7, wherein the access cap is configured tobe secured to the wound liner in an airtight manner.
 9. The tissuecontainment system of claim 6, wherein the access cap comprises an entryport configured to allow passage of a tissue removal device into theinterior region of the bag body.
 10. The tissue containment system ofclaim 9, further comprising an elongate bag introducer configured tointroduce the bag body into the abdominal cavity.
 11. The tissuecontainment system of claim 10, wherein the entry port is sized toprovide a passageway for the elongate bag introducer.
 12. The tissuecontainment system of claim 9, wherein the access cap further comprisesan insufflation port spaced apart from the entry port and configured fordelivery of fluid to the interior region of the bag body.
 13. The tissuecontainment system of claim 1, wherein the viewing window comprises arigid viewing window.
 14. The tissue containment system of claim 1,wherein the tissue removal device comprises a morcellator.
 15. Thetissue containment system of claim 1, wherein the tissue visualizationdevice comprises an endoscope.
 16. A method of containing a loose tissuespecimen within an abdominal cavity of a patient, the method comprising:introducing a containment bag into the abdominal cavity; moving a loosetissue specimen within the abdominal cavity into a main portion of thecontainment bag through an opening of an open-ended portion of thecontainment bag; positioning the open-ended portion of the containmentbag outside of the patient while the main portion is disposed within theabdominal cavity; positioning an invertible portion of the containmentbag outside of the patient while the main portion is disposed within theabdominal cavity; placing a tissue visualization device against aviewing window sealed to an end of the invertible portion disposedoutside of the patient; advancing the tissue visualization deviceagainst the viewing window into the invertible portion to cause theinvertible portion to form a double wall layer around the tissuevisualization device within the patient; and viewing an interior regionof the containment bag with the tissue visualization device through theviewing window.
 17. The method of claim 16, further comprisingmaintaining a part of the invertible portion outside of the body with aretainer that is attached to the invertible portion.
 18. The method ofclaim 17, wherein the retainer is adjustable from a first extent that issmaller than a wound within a wall of the abdominal cavity for passagethrough the wound to a second extent that is larger than the wound forretaining the invertible portion outside of the patient.
 19. The methodof claim 6, further comprising isolating the tissue visualization devicefrom the loose tissue specimen and from the abdominal cavity with theinvertible portion of the bag body and the viewing window.
 20. Themethod of claim 16, wherein the tissue removal device comprises amorcellator, and wherein the tissue visualization device comprises anendoscope.